Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial

OBJECTIVE

The study aims to determine the effects of Nd:YAG laser-assisted with subgingival scaling and root planing (SRP) treatment on glucose control and the dynamic changes of subgingival microbiome in periodontitis with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

Twenty-two patients were split into Nd:YAG group (n = 11) and SRP group (n = 11). Patients in the Nd:YAG group received SRP and auxiliary Nd:YAG laser treatment; patients in the SRP group received SRP treatment only. Periodontal tissue inflammation and glycemic control were assessed and analyzed during the treatment period and the changes of subgingival microbiome were analyzed by full-length 16S rRNA sequencing.

RESULTS

After 3 months of treatment, PD and CAL values improved significantly in the Nd:YAG group compared to the SRP group. BOP in both groups improved significantly after treatment. FPG levels in the Nd:YAG group were significantly reduced after treatment. Porphyromonas and Porphyromonadaceae were enriched in the Nd:YAG group at baseline, and Fusobacteriota, Fusobacteriia, Fusobacteriales, Leptotrichiaceae, and Leptotrichia were enriched after treatment.

CONCLUSION

Nd:YAG laser-assisted SRP therapy has additional benefits in improving periodontal tissue inflammation and blood glucose control in periodontitis patients with T2DM compared with SRP therapy alone and there was a trend towards a decrease in disease-associated taxa and an increase in health-associated taxa following auxiliary Nd:YAG laser treatment.

CLINICAL RELEVANCE

The effects of Nd:YAG laser-assisted SRP treatment on inflammation, glucose control, and subgingival microbiome in periodontitis patients with T2DM were elucidated, and new ideas for the treatment of T2DM periodontitis were provided.

Genetic variants in BCL-2 family genes influence the risk of non-syndromic cleft lip with or without cleft palate

BACKGROUND

The BCL-2 family is crucial for cell death regulation and is involved in development, tissue homeostasis, and immunity. This study aimed to investigate the association between genetic variants in BCL-2 family genes and non-syndromic cleft lip with or without cleft palate (NSCL/P) risk.

METHODS

A two-stage case-control study was conducted in this association study. Gene-based analysis using Multi-marker Analysis of GenoMic Annotation was performed in the first stage cohort, which included 565 cases and 1269 controls. A logistic regression model was employed to assess the effect of single nucleotide polymorphisms (SNPs) on susceptibility to NSCL/P. Candidate SNPs were replicated by extra dbGaP case-parent trios. Haploreg, RegulomeDB, and UCSC Genome Browser were used to identify enhancer effects of promising SNPs. Bulk RNA sequencing data obtained from the Gene Expression Omnibus was used to identify co-expressed genes. Single-cell RNA sequencing dataset was used to infer the cell population of the candidate gene. The "Monocle" package was used to analyze the pseudotime cell trajectories.

RESULTS

Rs3943258 located in the enhancer region was associated with the risk of NSCL/P (Pmeta  = 5.66 × 10-04 ) and exhibited an eQTL effect for BCL2 (P = 3.96 × 10-02 ). Co-expression and pathway enrichment analysis revealed that genes related to Bcl2 were significantly enriched in the PI3K-Akt signaling pathway, MAPK signaling pathway, and Wnt signaling pathway. Five cell clusters were identified in single-cell RNA sequencing, and Bcl2 was mainly located in the mesenchyme.

CONCLUSION

The rs3943258 located within BCL2 was probably related to NSCL/P susceptibility.

Characteristics of mandibular anterior alveolar bone in patients with different degrees of periodontitis: a retrospective study based on CBCT

OBJECTIVES

To investigate the alveolar bone characteristics of mandibular anterior teeth in patients with periodontitis.

MATERIALS AND METHODS

100 patients with periodontitis were selected and grouped according to the degrees of alveolar bone resorption, age, gender, and tooth type. The labial thickness of the alveolar bone, the degree of alveolar bone resorption, angulation between the long axis of teeth and alveolar process, alveolar bone height and density of the mandibular anterior teeth were measured.

RESULTS

There were significant differences in alveolar bone morphology between these three groups. Compared with the mild and moderate groups, the severe group showed that the alveolar bone in the half of the root crown was thickened, the alveolar bone height was decreased, the cancellous alveolar bone density was increased, and the cortical alveolar bone density was decreased. The resorption of alveolar bone was characterized by greater resorption of proximal bone than that of labial bone with increased bone loss. There were also differences in alveolar bone characteristics among patients of different ages, genders, and tooth types.

CONCLUSIONS

The morphology of the mandibular anterior alveolar bone changed accordingly with the degree of periodontitis. Labial alveolar bone thickness and cortical alveolar bone density were negatively correlated with the degree of periodontitis, while alveolar bone height and cancellous alveolar bone density were positively correlated with the degree of periodontitis.

CLINICAL RELEVANCE

These results allow clinicians to better understand the alveolar bone morphology of the mandibular anterior teeth in patients with periodontitis, facilitating better treatment design and avoiding complications.

Changes of maxillary central incisor and alveolar bone in Class II Division 2 nonextraction treatment with a fixed appliance or clear aligner: A pilot cone-beam computed tomography study

INTRODUCTION

This retrospective clinical study investigated the clinical changes of maxillary central incisor and alveolar bone in Class II Division 2 nonextraction treatment with fixed appliances or clear aligners on the basis of cone-beam computed tomography.

METHODS

Fifty-nine Chinese Han patients with similar demographic characteristics were collected from a conventional bracket group, a self-ligating bracket group, and a clear aligner group. All measurements about root resorption and alveolar bone thickness on the cone-beam computed tomography images were tested. Changes between pretreatment and posttreatment were evaluated by paired-sample t test. The variation among the 3 groups was compared by 1-way analysis of variance.

RESULTS

The resistance center of the maxillary central incisor showed upward or forward movement, and the axial inclination was increased in 3 groups (P <0.0001). Root volume loss in the clear aligner group (23.68 ± 4.82 mm³) was significantly less than that in the fixed appliances group (28.24 ± 6.44 mm³ in the conventional bracket group, 28.17 ± 6.07 mm³ in the self-ligating bracket group) (P <0.05). All 3 groups showed a significant decrease in palatal alveolar bone and total bone thickness at all 3 levels at posttreatment. In contrast, labial bone thickness significantly increased except for crestal level l. Among the 3 groups, the clear aligner group had a prominent increase in labial bone thickness at the apical level (P = 0.0235).

CONCLUSIONS

Clear aligner treatment for Class II Division 2 malocclusions could effectively reduce the incidence of fenestration and root resorption. Our findings will be beneficial to comprehensively understand the effectiveness of different appliances for Class II Division 2 malocclusions treatment.

Biological Efficacy Comparison of Natural Tussah Silk and Mulberry Silk Nanofiber Membranes for Guided Bone Regeneration

Biopolymer nanofiber membranes are attracting interest as promising biomaterial scaffolds with a remarkable range of structural and functional performances for guided bone regeneration (GBR). In this study, tussah silk nanofiber (TSn) and Bombyx mori silk nanofiber (BSn) membranes were prepared by physical shearing. The diameters of the TSn and BSn membranes were 146.09 ± 63.56 and 120.99 ± 91.32 nm, respectively. TSn showed a Young's modulus of 3.61 ± 0.64 GPa and a tensile strength of 74.27 ± 5.19 MPa, which were superior to those of BSn, with a Young's modulus of 0.16 ± 0.03 GPa and a tensile strength of 4.86 ± 0.61 MPa. The potential of TSn and BSn membranes to guide bone regeneration was explored. In vitro, the TSn membrane exhibited significantly higher cell proliferation for MC3T3-E1 cells than the BSn membrane. In a cranial bone defect in a rat model, the TSn and BSn membranes displayed superior bone regeneration compared to the control because the membrane prevented the ingrowth of soft tissue to the defective area. Compared to the BSn membrane, the TSn membrane improved damaged bone regeneration, presumably due to its superior mechanical properties, high osteoconductivity, and increased cell proliferation. The TSn membrane has a bionic structure, excellent mechanical properties, and greater biocompatibility, making it an ideal candidate for GBR.

The profiling of amino acids in crop milk and plasma and mRNA abundance of amino acid transporters and enzymes related to amino acid synthesis in the crop tissue of male and female pigeons during incubation and chick-rearing periods

The present study was carried out to investigate the changes in amino acid (AA) contents of crop milk and plasma and mRNA abundance of AA transporters and AA synthesis-related enzymes in the crop tissue of male and female pigeons during incubation and chick-rearing periods. Forty-two pairs of adult White King pigeons with 2 fertile eggs per pair were randomly divided into 7 groups by different breeding stages. The AA content of crop milk decreased from day 1 (R1) to day 25 (R25) of chick rearing (P < 0.05). In both male and female adult pigeons, the contents of Thr, Leu, Val, His, Asp, and Pro in plasma increased to maximum levels on R25. Parental sex effect and interaction between stage and sex were observed in the AA contents of pigeon plasma (P < 0.05). For AA transporters, the mRNA abundances of SNAT2, ASCT1, LAT1, and y+LAT2 in the male crops reached the highest value on day 17 of incubation (I17), and the peak mRNA levels of PAT-1, xCT, b0,+AT, and CAT1 were found on R7 (P < 0.05). In females, the abundances of ASCT1, B0AT1, asc-1, and CAT1 mRNA peaked on R1, whereas the maximum levels of LAT1, PAT-1, b0,+AT, and y+LAT2 were observed on R7. For enzymes involved in AA synthesis, the highest gene expressions of glutamate dehydrogenase 1, acetolactate synthase in both parent pigeons, and L-threonine 3-dehydrogenase in female pigeon crops were attained on I17. The expressions of ornithine-δ-aminotransferase, glutamic-oxal(o)acetic transaminase 1, glutamic-oxal(o)acetic transaminase 2, asparagine synthetase, serine hydroxymethyltransferase 2, and glutamic-pyruvic transaminase 2 in both sexes and argininosuccinate lyase and L-threonine 3-dehydrogenase in males were the highest on R1. In conclusion, AA used for pigeon crop milk formation may originate from plasma and intracellular synthesis. The genes involved in AA transport and synthesis varied significantly with sexual effects, indicating that other factors should be considered in future explorations of the mechanism of protein formation in crop milk.

Genetic polymorphisms in pattern recognition receptors and risk of periodontitis: Evidence based on 12,793 subjects

Pattern recognition receptors (PRRs) constitute a pivotal arm of innate immunity. Many studies investigated the association between PRRs polymorphisms and periodontitis risk, which showed inconclusive results. The aim of the meta-analysis was to evaluate the precise association between five widely-evaluated polymorphisms (CD14 -260C/T (rs2569190), Toll-like receptor (TLR) 2 2408G/A (rs5743708), TLR4 896A/G (rs4986790), TLR4 1196C/T (rs4986791), mannose-binding lectin (MBL) codon 54 (rs1800450)) within the PRRs and susceptibility to either chronic (CP) or aggressive periodontitis (AgP). Overall, no significant association was found for the PRRs polymorphisms with either CP or AgP. In the subgroup analyses, TLR4 896G and 1196T alleles yielded a 32% (OR=1.32, 95% CI: 1.04-1.68) and a 37% increased CP risk (OR=1.37, 95% CI: 1.05-1.80) in Caucasians, respectively. Further stratified analyses revealed links between CD14, MBL2 polymorphisms and the severity of CP. This meta-analysis suggested that the periodontitis susceptibility was partly controlled by PRRs polymorphisms involved in the innate immunity.

Hypoxia regulates the proliferation and osteogenic differentiation of human periodontal ligament cells under cyclic tensile stress via mitogen-activated protein kinase pathways

BACKGROUND

Previous studies have shown that periodontal ligament exists in a hypoxic microenvironment, especially under the condition of periodontitis or physical stress. The present study is designed to investigate the effects and mechanisms of hypoxia on regulating the proliferation and osteogenic differentiation of human periodontal ligament cells (hPDLCs) under cyclic tensile stress (CTS).

METHODS

hPDLCs were cultured in 2% O2 (hypoxia) or 20% O2 (normoxia) and then subjected to a cyclic in-plane tensile deformation of 10% at 0.5 Hz. The following parameters were measured: 1) cell proliferation by flow cytometry; 2) cell ultrastructure by transmission electron microscopy; 3) expression of hypoxia-inducible factor-1α (HIF-1α) and osteogenic relative factors (i.e., secreted phosphoprotein 1 [SPP1; also known as bone sialoprotein I/osteopontin], runt-related transcription factor 2 [RUNX2], and transcription factor Sp7 [SP7]) by real-time polymerase chain reaction and Western blot; and 4) involvement of mitogen-activated protein kinase (MAPK) signaling pathways by Western blot with specific inhibitor.

RESULTS

Proliferation index in the hypoxia with CTS group was significantly higher than in other groups. Significant increases in HIF-1α, SPP1, RUNX2, and SP7 occurred in the presence of hypoxia for 24 hours. In addition, MAPK inhibitor (PD 98,059) significantly attenuated hypoxia and CTS-induced phosphor-ERK1/2 (extracellular regulated kinase 1/2), phosphor-JNK (c-jun N-terminal kinase), and phosphor-P38 expression.

CONCLUSIONS

Hypoxia regulates CTS-responsive changes in proliferation and osteogenic differentiation of hPDLCs via MAPK pathways. Hypoxia-treated hPDLCs may serve as an in vitro model to explore the molecular mechanisms of periodontitis.

Cyclic tensile stress during physiological occlusal force enhances osteogenic differentiation of human periodontal ligament cells via ERK1/2-Elk1 MAPK pathway

Physiological occlusal force constitutively exists in the oral environment and is important for periodontal homeostasis and remodeling. Cyclic tensile stress (CTS) triggers the biological response of periodontal ligament (PDL). However, a few reports have studied the correlation between CTS during physiological occlusal force and PDL cell activities such as osteogenic differentiation. In the present study, human PDL cells (hPDLCs) were subjected to 10% elongation CTS loading at 0.5 Hz for 24 h, which represents the physiological conditions of occlusal force. Gene expression microarray was used to investigate the mechano-induced differential gene profile and pathway analysis in vitro. The osteogenic relative factors, that is, SPP1, RUNX2, and SP7, were assessed by real-time PCR and Western blot. The involvement of mitogen-activated protein kinase (MAPK) signaling pathways was investigated by Western blot with a specific inhibitor. The expressions of SPP1, RUNX2, SP7, p-ERK1/2, and p-Elk1 were up-regulated after 10% CTS exposure. However, these up-regulated expressions were prevented by ERK1/2 inhibitor U0126 in the physiological occlusal force-applied hPDLCs. These results showed that 10% CTS could enhance osteogenic differentiation of hPDLCs via ERK1/2-Elk1 MAPK pathway, indicating that CTS during physiological occlusal force is a potent agent for PDL remodeling.

Abstract P4-09-09: Circulating HER2 extracellular domain (ECD) levels are associated with progression-free survival in metastatic breast cancer patients

Background: The human epidermal growth factor (HER2/neu) oncoprotein is composed of an intracellular tyrosine kinase portion, a short transmembrane section, and an extracellular ligand-binding domain (ECD). The latter is frequently cleaved from the surface of breast cancer cells and the serum HER2 ECD levels can be detected by enzyme-linked immunosorbent assay (ELISA). Consistent with majority of reports, our prior study showed that high circulating levels of the HER2 ECD indicates poor prognosis in 207 patients with metastatic breast cancer. In the present study, we aimed to elucidate whether serum HER2 ECD levels would predict the clinical outcome of metastatic breast cancer patients.

Methods: Till May 19, 2012, one hundred ninty metastatic breast cancer patients were followed up. Serum was available from 190 patients at baseline, 46 patients in the assessment of time. Serum HER2 ECD levels were measured by ELISA. Disease state was assessed using Response Evaluation Criteria in Solid Tumors (RECIST). Progression-free survival (PFS) was defined as the interval from the time of randomization until the first documentation of disease progression or death due to any cause. PFS and median PFS were generated by Kaplan-Meier spots.

Results: Elevated baseline HER2 ECD levels (bECD) (≥15 ng/ml) were observed in 40% (40/100) of patients with HER2-amplified tumors and 21.8% (19/87) of patients with HER2-negative tumors. Patients with bECD-elevated disease had a median PFS of 356 days compared with 229 days for patients with bECD-low disease(P = 0.001). In HER2-amplified cohort, median PFS for patients with low bECD levels was longer than those with bECD-elevated disease (391 days v 226 days, P = 0.005). And patients with low bECD levels treated with Herceptin-based regimen (n = 36) had a trend of longer PFS than patients(n = 24) treated with non-Herceptin regimen(447 days v 298 days, P = 0.227). Moreover, bECD-low patients (n = 36) showed a significantly longer median PFS than bECD-elevated patients(n = 22) when treated with Herceptin-based scheme (447 days v 229 days, P = 0.004). While, in patients with increased bECD levels, there was no statistical difference between Herceptin-treated groups (n = 22) and non-Herceptin-treated groups (n = 14) (229 days v 173 days, P = 0.761). In the HER2-negative group, patients with bECD-low disease had a median PFS of 313 days compared with 206 days for patients with bECD-elevated disease (P = 0.02). In a cohort of 46 patients whose HER2 ECD levels were monitored during treatment, 29 patients remains low ECD levels, 12 patients convert from elevated to low, 2 patients convert from low to high, and 3 patients remains elevated HER2 ECD levels. The patients who remained low ECD levels or achieved low ECD leves have significantly longer PFS than those whose levels remained above 15ng/mL or converted from low to high regardless of treatment given (440 days v 192days, P = 0.019).

Conclusion: Elevated HER2 bECD predicts poor median PFS irrespective of HER2 status. HER2-amplified patients with low-HER2 ECD levels may get more benefit from Herceptin-based scheme. Remained low-HER2 ECD levels or decreases in serum HER2 ECD levels during treatment were associated with longer median PFS in metastatic breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-09-09.

Abstract P2-05-05: Circulating HER2 extracellular domain (ECD) predicts a poor prognosis for metastatic breast cancer patients

Background: Amplification or overexpression of HER2 has been shown to play an important role in approximately 30% of breast cancers and is strongly associated with increased recurrence and a worse prognosis. The HER2 extracellular domain (ECD) may be cleaved and shed from the surface of breast cancer cells and serum HER2 ECD levels can be detected by enzyme-linked immunosorbent assay (ELISA). In this study, we explored the relationship between circulating HER2 ECD and tissue HER2 status, then we also examined its predictive value in a cohort of metastatic breast cancer patients.

Methods: Two hundred and seven metastatic breast cancer patients from March 2009 to July 2011 were involved in this prospective study at Zhejiang Cancer Hospital. The patients were identified histopathologically as having breast cancer by pathologists and staged mainly based on the pathology, the clinical manifestation, and the imaging findings of CT and MRI according to the classification system of the International Union Against Cancer. Serum HER2 ECD levels were measured by ELISA. Tissue HER2 was determined by IHC and FISH in tumor samples, respectively.

Results: The level of serum HER2 ECD was at least more than 15 ng/ml in 31.4% (65/207) metastatic breast cancer patients, 39.1%(43/110) in HER2-positive patients and 23.4%(22/94) in HER2-negative cases, respectively, P = 0.017. We also found that high serum HER2 ECD levels (≥15 ng/ml) were significantly associated with elevated serum CEA (52.1% v 21.5%, OR 3.978, 95%CI 2.138–7.401, P = 0.000), CA125 (48.5% v 23.5%, OR 3.064, 95%CI 1.650–5.691, P = 0.000), CA153 (53.2% v 17.1%, OR 5.48, 95%CI 2.897–10.366, P = 0.000), LDH (53.3% v 23.1%, OR 3.798, 95%CI 2.011–7.173, P = 0.000) and AKP (51.2% v 26.5%, OR 2.911, 95%CI 1.442–5.879, P = 0.002), respectively. For the effect of HER2 ECD on the site of relapse, still there were statistically significant correlation between increased serum HER2 ECD levels and liver involvement (42.7% v 24.0%, OR 2.358, 95%CI 1.294–4.297, P = 0.005), brain metastasis (50.0% v 26.7%, OR 2.744, 95%CI 1.397–5.391, P = 0.003) and visceral involved (37.9% v 14.8%, OR 3.511, 95%CI 1.548–7.961, P = 0.002), respectively. While serum HER2 ECD levels were not related to age, BMI, tumor size, lymph node involvement and hormone receptors status, respectively (P&gt;0.05).

Conclusions: Monitoring the circulating levels of the HER2 ECD in patients with metastatic breast cancer provides a real-time assessment of tumor burden and indicates poor prognosis, and may provide important information for reassessment of HER2 in HER2-negative metastatic breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-05-05.

[Study on syndrome pattern in insulin resistant model rats]

OBJECTIVE

To explore the Syndrome pattern in insulin resistant model rats.

METHODS

Eight Sprague-Dawley (SD) rats were induced to insulin resistance (IR) by 60% high-sucrose forage.

RESULTS

The correlative co-efficient of some biological and internal changes were clusterly analyzed and divided into 3 groups, which was closely related with phleg tubidity, blood stasis and internal toxin types respectively. The phlegm turbidity type was characterized by high content of blood lipid (triglyceride, total cholesterol) and high concentration of glycated serum protein; the blood stasis type was characterized by tendency of high viscosity and high coagulant state, the blood pressure increased, prothrombin time shortened, fibrinogen content raised and RBC and platelet count increased; while the internal toxin type was characterized by high content of glucose, insulin and the elevation of tumor necrosis factor.

CONCLUSION

The combined Syndrome of phlegm turbidity, blood stasis and internal toxin is the Syndrome-pattern in insulin resistant model rat. This observation provides theoretic basis for clinical and experimental studies of TCM.

[Clinical observation on relationship of antioxidation criteria and immune function of erythrocyte in patients with asthenia syndrome]

Results of observation on 31 patients of Qi-Yin Deficiency Syndrome showed that as compared with normal person, the superoxide dismutase (SOD) activity of erythrocyte in patients was lowered, the content of serum lipid peroxide (LPO) increased, the rosette rate of red cell C3b receptor (RC3 bRR) lowered but that of red cell immune complex was elevated significantly (P < 0.01). There were a positive correlation between erythrocyte SOD activity and RC3bRR (r = 0.381, P < 0.05), and a negative correlation between serum LPO level and RC3bRR (r = -0.395, P < 0.05).

[Effect of fushen decoction on thyroid hormone in chronic glomerulonephritis of both spleen and kidney-yang deficiency patients]

Changes of thyroid hormone level before and after treatment in 45 patients with chronic glomerulo-nephritis were observed. Of which, 23 cases were treated with Fushen Decoction and the other with Shenyan Siwei tablet as control. The results showed: (1) The level of serum T3 and T4 of 45 patients were significantly reduced (P < 0.001-0.01). (2) The level of serum T3 and T4 were significantly negative correlated with the value of BUN and Scr and the score of both Spleen and Kidney-Yang Deficiency Syndrome (P < 0.01-0.05), but there existed no significant negative correlation with urinary protein excretion in 24 hours (P > 0.05). (3) After treatment with Fushen Decoction, the level of serum T3 and T4 significantly increased (P < 0.01-0.05), but no significant change was recorded in control group (P > 0.05). (4) Although the level of serum T3 and T4 were raised, they were still lower than those of normal people.